The effects of nicotine on your developing baby

PORTSMOUTH — In theory, people know that smoking while pregnant is a bad idea, but understanding the risks might help expectant parents make the right decision.

Karen Dandurant

PORTSMOUTH — In theory, people know that smoking while pregnant is a bad idea, but understanding the risks might help expectant parents make the right decision.

Nicotine is known to be a substance that crosses the placenta. It concentrates in fetal blood and amniotic fluid and it is even detectable in breast milk. Even second-hand smoke can have an impact on the unborn baby.

Nicotine goes directly to the fetus if the baby is exposed while a mother is pregnant. Also, there are other toxic substances in tobacco including carbon monoxide.

In an unborn child, nicotine can lower the amount of oxygen available to the baby. It can increase heart rate and lead to lung development problems. Nicotine use increases the risk of miscarriage and still births, and it can result in low birth weight or premature births.

Dr. Jacqueline Baselice, an OB/GYN from Partners for Women's Health in Exeter, said she encourages her patients to quit smoking while they are pregnant, and to stay off cigarettes following the birth of their child.

"Many women are motivated to quit while they are pregnant and they do," Baselice said. "The problem is that they start again. Once you quit, quit. Why would you want to smoke around your child after they are born?"

Dr. Heidi Keup of Harbour Women's Health in Portsmouth said pregnancy is a great opportunity to get women to quit, but she also sees many mothers return to cigarettes once the baby has been born.

"For some women, it is a coping mechanism once they are dealing with a new baby," Keup said of smoking. "Many will do their best around the baby. They go outside to smoke and they will change clothes before being around the child. It may help a lot if the other people in the house are supportive. It's hard to quit if your husband smokes. Plus, then you have the issue of second-hand smoke, which is also a risk."

Baselice said the biggest issue with unborn children and smoking is that they receive less oxygen and she feels that contributes greatly to low birth weight and premature babies. She said most people know smoking increases the risk of miscarriage. But she said smoking while pregnant is a factor in several other pregnancy problems such as preeclampsia and the early rupturing of membranes and it is likely a factor in sudden infant death syndrome.

"The babies do not see as much oxygen because smoking affects the way the placenta is structured," Baselice said. "That leads to the baby not receiving sufficient oxygen. The developmental issues can lead to all the other known problems and to (sudden infant death syndrome). I believe that letting patients know the risks is a huge motivating factor in convincing them to quit smoking."

In studies, no level of nicotine exposure has been determined safe for a fetus. Also, there are no long-term studies showing the use of smoking cessation products such as a patch or nicotine gum is safe for an unborn child. Doctors will use the products if the risk to the mother and child is considered greater if the mother continues to smoke.

"There is no evidence that says nicotine replacement therapy used to get off of cigarettes puts women at a higher risk," Baselice said. "It does lower the blood levels of nicotine and the woman is not exposing the baby to the other carcinogens present in cigarettes."

Keup said she classifies smokers and approaches to cessation in two ways. If a smoker is not dependent on cigarettes, meaning they smoke less than a pack a day and do not need to smoke as soon as they get up, Keup will try to wean them off cigarettes rather than using smoking cessation products.

People who smoke a pack or more a day and need to have a cigarette within 30 minutes of rising in the morning are considered dependent. In those cases, Keup said she urges the use of smoking cessation products to try and help kick the habit.

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